| Objective:Through a comparative study on the treatment of two methods of osteoporotic compression fractures of thoracolumbar vertebrae,one is improved Bone-setting manipulation named Panmenzhuaishenfa combined with Percutaneous vertebroplasty(PVP),another one is simple Percutaneous vertebroplasty.To analyze the clinical efficacy,mechanism,safety and clinical value of improved Bone-setting manipulation combined with Percutaneous vertebroplasty in treating thoracolumbar osteoporotic fractures.Method:Between January 2016 and January 2017,80 patients(80 vertebrae)were diagnosed with osteoporotic compression fractures of thoracolumbar vertebrae who were hospitalized in Zhengzhou Orthopedic Hospital.Forty patients underwent improved Bone-setting manipulation named Panmenzhuaishenfa combined with Percutaneous vertebroplasty,the other40 patients directly using Percutaneous vertebroplasty treatment.The VAS pain score,the vertebral compression rate and the Cobb angle were recorded before the operation,1 day after the operation,1 month after the operation and 3 months after the operation.And the lumbar pain score of JOA was recorded by a questionnaire.Finally,the clinical efficacy and safety of the two groups were compared and recorded.Results: 80 patients were followed up,there was no significant difference between the two groups before surgery(P>0.05).After follow-up,the Bone-setting manipulation combined with PVP group preoperative VAS pain score was 7.71±0.69,after surgery was 2.35±0.62,and PVP group preoperative VAS pain score was 7.65±0.73,after surgery was 2.55±0.77.As a result,there was no statistically significant difference in VAS scores between the two groups(t = 1.279,P = 0.204>0.05).The percentage of high degree of compression of the front of the vertebral injury of the two groups was compared,the combined treatment group before the treatment was13.21±5.16,after was 30.31±5.56,the PVP group before treatment was30.64±6.03,after treatment was 17.03±5.14.As a result,the combination group was better than the PVP group,the difference was statistically significant(t = 3.317,P = 0.001<0.01).Before treatment,the Cobb angle of the combined group was 17.01±3.57,and the PVP group was 17.27±3.93;after treatment,the Cobb angle of the combined group was 7.12±2.98,and that of the PVP group was 14.52±3.09;so the difference was statistically significant(t = 10.902,P < 0.01).Before treatment,the lumbar pain score of JOA recorded by a questionnaire of the combined group was 17.01±0.82,and the PVP group was 16.97±0.97;after treatment,the combined group was24.85±2.26,and that of the PVP group was 20.45±1.93;so the difference was statistically significant(t =-9.363,p < 0.01);according to the evaluation criterion of the improvement rate of low back pain score in JOA,after the treatment of 40 cases of the combined group were excellent in 13 cases,good in 21 cases,moderate in 5 cases,poor in 1 case,the effective rate was 97.5%;after the treatment of 40 cases of the PVP group were excellent in 8 cases,good in 19 cases,moderate in 7 cases,poor in 6 cases,the effective rate was 85%.There were 2 cases of complication in 40 cases of the combined treatment group,which were related to bone cement,and the average operation time was(40.53±3.26)min;there were 5 cases of complication in 40 cases of the PVP treatment group,which were related to bone cement,but no spinal cord,nerve root,abdominal aortic pressured phenomenon,and the average operation time was(38.95±3.69)min;the operation time of the combined treatment was more than that of PVP group,and the difference was statistically significant(t =-2.029,P = 0.045<0.05).Conclusion: 1.Manipulative reduction combined with PVP and simple PVP in the treatment of thoracolumbar osteoporotic fractures all had obvious effect,and the combined group had better results in the Cobb angle recovery 、 recovery of vertebral compression rate and functional recovery.2.The two groups all had significant effect in the treatment of pain,but no significant difference.3.The time required for combined surgery was slightly more than that of PVP alone,but the difference was not significant.In summary,improved Bone-setting manipulation named Panmenzhuaishenfa combined with Percutaneous vertebroplasty had more advantages in treating osteoporotic compression fractures of thoracolumbar vertebrae. |
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